Away from her friends and regular routine, London teenager Eesha Parashara developed an eating disorder during the UK’s first national lockdown, which began last March.
Isolation and loneliness, coupled with social media, proved a toxic combination.
“When I ate every meal, my stomach would hurt for about an hour,” Parashara, 17, recalled. “Then not going to the toilet for about two weeks or three weeks. And obviously I was really bloated. And then I looked at my body in different ways. So why am I putting on weight? Why am I not going to toilet? Is there something wrong?”
Despite knowing the pitfalls, she kept comparing herself to others online.
“It is a big influence on the way you think,” she said. “Everyone else, when you’re on social media, they put up all the good parts. They never put up the negative parts of how they’re feeling, the way they look. It’s all the good angles. And you’re sat at home thinking: Why don’t I look like that?”
As light began to appear at the end of the pandemic tunnel, Parashara said she felt additional anxiety about returning to school and normal life, fearing that the opportunities for social development, important for her future at university, are irretrievably lost.
Her concerns echo the anxieties of many adolescents grappling with uncertain futures. Teenage life was stressful before the pandemic, and now memories of lockdown weigh heavy on the collective psyche.
The Prince’s Trust annual survey of young people’s happiness returned its worst findings yet at the start of this year.
One in five young people aged 16 to 25 had experienced suicidal thoughts since the start of the pandemic, 10% had self-harmed, and 22% had experienced panic attacks, according to the charity that works with young people.
Evolving effects
Dr Jide Menakaya, Eesha’s doctor and a pediatric gastroenterology consultant at Hillingdon Hospital in West London, has seen a large increase in the number of referrals for children with eating disorders.
“Being aware of the mental health issues or emotional wellbeing issues in those children is incredibly important because, unless one addresses those, it’s very difficult to get a handle on the physical side of things,” Menakaya said.
Healthcare professionals warn that anxieties and depression, if left unchecked, can lead to acute illness later. Far from evaporating as lockdown restrictions ease, the effects will continue to evolve.
Chris Mann, head nurse at Hillingdon Hospital, pointed to climbing admission rates for children presenting with abdominal pains and deliberate self-harm.
“It’s the child’s way of telling us, and we’ve got to get smart at listening to children,” she said.
“We’re seeing double the amount, triple the amount of children we used to pre-Covid being admitted … with a variety of self-harm,” Mann said. “That’s children drawing attention to the fact that they’ve got a concern.”
One in six children in the UK is now suffering with a diagnosable mental health issue, according to government data, up from one in nine in 2017.
Those from disadvantaged backgrounds were more likely to be disproportionately impacted by lockdown and are emerging as the pandemic’s collateral damage.
“Many families have had a really hard year,” said Jo Casebourne, chief executive of the Early Intervention Foundation. “They’ve been living with financial strain and uncertainty.”
Forcing children to remain indoors, sometimes in cramped or volatile households, “can lead to things like increased parental conflict and children experiencing domestic abuse,” Casebourne said. “I think it’s fair to say that the lockdown will have impacted some children more than others.”
Research commissioned by the Early Intervention Foundation indicates 42% of parents with a household income under ￡34,999 ($48,947) reported their child’s mental health had worsened, compared with 28% of parents with a household income of more than ￡55,000 ($76,920).
“Gaps that were already there before Covid between the most disadvantaged children and their peers will actually widen,” Casebourne added. “It’s really important that we don’t let the weight of the pandemic fall hardest on the shoulders of the poorest children and families.”
Clinical psychologist and founder of the teenage mental health charity stem4, Dr Nihara Krause points to shortfalls in treatment and intervention services while the country dealt with the Covid-19 emergency.
When stem4 surveyed 500 schoolteachers in December 2020, 34% responded to say referrals for students with mental health difficulties were routinely rejected because they do not meet the threshold of severity. “It’s not right to ask children to get worse in order to get seen,” Krause said.
“Less privileged children inevitably fall through the gaps of an oversubscribed and under-resourced support network.”
‘It was hell’
CNN visited Unitas, an OnSide Youth Zone in North London that was built with private funding in 2019, partly in response to rising poverty levels in the local area. It had re-opened four weeks ago after shutting it doors earlier this year as the UK entered a third national lockdown.
“For our generation with Covid-19, it’s mental health. So many young people I know have been getting anxiety and depression. It’s like post-traumatic stress disorder,” 17-year-old Taylor Dawson told CNN.
Dawson gathers with a group of teenagers once a week at Unitas. Before meeting in person, the group met online during lockdown to hold “Healthy Mind, Healthy Body” sessions. During the session, a youth worker guides them through breathing and mindfulness techniques and encourages each group member to share their experiences.
Fears around contracting or passing on the virus to family members dominated the conversation. Saturated with non-stop Covid news and warnings about missed schoolwork, the teenagers speak openly of what they describe as paranoia.
“All you heard on the news was about Covid, Covid, Covid,” said Bradley Smith. 16. “That was stressing people out as well.”
“It created this gray cloud over my entire life,” said 18-year-old Sarah Brown. “It was hell.”
“I used to be at the top of my class. I used to have the best grades but because of the transition of moving from a classroom to online, I wasn’t able to get the support I regularly had,” she said. “It crumbled a lot of good things.”
Schools were closed for much of the academic year in the UK, which moved counseling and mentoring services online and out of reach for many. Outposts like Unitas provided their own virtual services to help fill the need.
The government has pledged ￡79 million ($112 million) over the next three years toward expanding mental health services in schools and colleges across the UK.
Children, like adults, are now beginning to understand the scale of the impact lockdown has had on their mental health. Many will have experienced bereavement, neglect, and hardship, often behind closed doors.
“Social distancing is a misnomer and the opposite of what kids need,” said Dr. Menakaya, Eesha’s doctor. “Social and emotional closeness are more important than ever.”